Respecting the use of arsenic in asthma, Prosper Alpinus remarks: “Præterea audent aliqui arsenicum summè exitiale venenum illis exhibere. Narrant quidam nepotem patris fratri decrepito orthopnoico, ut cum interimeret, clam in ferculo ex cucurbitâ parato porrexisse arsenicum, coque non modo non interimisse decrepitum, verum et ab asthmate prorsus sanasse.” (De Meth. Med. x, 13.) He states further, by the way, both in that work and in the one “de Medicina Ægyptiorum,” that the Egyptians were in the practice, for the cure of asthma, of applying cones of cotton to the breast, and setting them on fire. Fracastorius, who recommends this practice of imbibing the fumes of arsenic, for contagious phthisis, speaks of it in the following terms: “Nonnulli antiquorum jubent Sandaracæ nidorem per anhelitum in pulmones trahi: quum autem Sandaracam dico non eam intelligi volo quæ vernix vulgo vocatur, sed quæ auripigmentum a nobis dicitur: porro nec per auripigmentum velim a te accipi priorem illam speciem quæ citrina est sed alteram, quæ est ruffa, et propriè Sandaraca vocatur.” (Morb. Contag. iii.)
Dr. Hill, however, properly remarks that the arsenic of the ancients, or orpiment was a much more innocent substance than the factitious arsenic of the moderns. See also Cleaveland (Mineralogy p. 680.) The arsenic of the ancients, in fact (as will be shown in the proper place), was the mineral substance called yellow orpiment, consisting of sixty-two parts of arsenic and thirty-eight of sulphur, according to the analysis of Klaproth. The sandarach was realgar, which consists of seventy-five parts of arsenic and twenty-five of sulphur.
SECT. XXX.—ON PERIPNEUMONIA.
Peripneumonia is an inflammation of the lungs, supervening, for the most part, upon violent catarrhs, cynanche, asthma, pleurisies, or other complaints, but being sometimes the original affection. It is accompanied with difficulty of breathing, an acute fever of the ardent type, weight and tightness of the chest, a râle, a seizure of the face with great fulness, the morbific matter being determined upwards like fire. Wherefore the cheeks appear red, the eyes swelled, with falling down of the eyebrows, and the cornea appears somewhat glossy. When the symptoms incline to a more ardent type, it is to be apprehended that the inflammation is of an erysipelatous nature. When the disease originates from the conversion of other diseases into this, we must not have recourse to venesection, more especially if the diseases be of a chronic nature, and if blood had been previously let. But, in the remissions, clysters are to be injected into the bowels, which are moved with difficulty; or, when nothing contra-indicates, large cupping-instruments with scarifications may be frequently applied to the breast and sides. But if the peripneumonia was the original affection, and the strength permit, we must open a vein; or if not, we may cup, proportioning the evacuation of blood to the powers of the patient. Let draughts of the juice of ptisan, or of chondrus with honey, be taken, or from bitter almonds with semilago, or chondrus having some sweet potion mixed with it, such as hydromel, apomel, or hydrorosatum. Fresh butter to the extent of three spoonfuls is also proper. The patient must also drink the propoma of the decoction of figs with hyssop, or of iris boiled in honied water, or of powdered iris, to the amount of two spoonfuls sprinkled upon honied water. This also evacuates downwards. To keep up the strength, he should be made to drink frequently of honied water alone, and with pine-nuts, and the seed of cucumbers. And cupping-instruments and the cerate of privet, having some iris sprinkled upon it; or the cerate of the oil of rue and dried iris; or that made of wax, and rosin, marrow, butter, hyssop, dried iris, and nard ointment, may be applied to the whole chest and sides.
Commentary. The reader is referred to the authorities on pleurisy, as most of them treat of both diseases together.
Hippocrates recommends bleeding, purging, and attenuant drinks as his general plan of treatment. If the appendix to his treatise on the Regimen in Acute Diseases be genuine he approved of carrying venesection the length of inducing deliquium.
Aretæus gives a minute and faithful account of the disease, but his description is too long for our limits. He remarks that as the lungs have but small nerves, there is little pain unless the investing membrane be affected. He states that when the suppuration takes place, a metastasis of the matter to the bladder or belly sometimes occurs and relieves the patient, whereas, if it be determined to the lungs, it is apt to terminate in phthisis. He gives excellent directions for the application of his remedies, which are the same as those now in use, namely, copious bleeding (but so as to avoid deliquium), purging, attenuant and diluent drinks, rubefacients, containing mustard, to the chest, alkaline substances, such as soda, given in the decoction of hyssop; and when the fever has subsided he allows wine devoid of astringency.
Aëtius makes the same remark as Aretæus respecting the metastasis of the matter. His account of the disease is excellent, but like our author’s.
Celsus properly states that the danger is greater than the pain. His account of the treatment is too long for our limits, but is well deserving of attention.
According to Actuarius, in hot affections of the lungs the urine is first a bright yellow, but if the disease gain ground, and dyspnœa and thirst supervene, the urine becomes red and of a dark wine colour. (De Urinis, vii, 5.)